Evidence assessment of the impacts of the criminalisation of the purchase of sex: a review

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Author and publication date	Research Design	sample size/response rate	Country	Themes	Limitations and gaps of research
Amnesty International (2016) The Human Cost of 'Crushing' the Market	Interviews with women who currently or previously sold sex, representatives of social support services for people who sell sex, and government agencies, civil society organisations, lawyers and academic/social researchers.	54 interviews in total, 30 of which were with women who currently or previously sold sex.	Oslo, Norway.	Impacts of legislation in Norway - November 2014-February 2015	Report is one of a series undertaken by AI to document human rights abuses experienced by sex workers and frames the research in this context. Selection criteria arranged via NGOs.
Danna, D. (2012) 'Client-Only Criminalisation in the City of Stockholm: A Local Research on the Application of the "Swedish Model" of Prostitution Policy"'	Case-study examining the application of the Act in Stockholm in March 2006. Methods: (i)Interviews with 'observers' including researchers, police officers, practitioners from a social services street unit and sex workers. (ii)Content analysis of 1,042 newspaper articles. (iii)Observations and informal talks with sex workers and clients in a specific street where prostitution takes place in Stockholm over 4 weeks. (iv)Also includes discussion of evaluations made by other researchers on Swedish prostitution and trafficking laws.	12 interviews, analysis of 1,042 newspaper articles containing the word prostitution, observations and informal talks with sex workers over a month in 2006.	Sweden	Impacts of criminalisation of purchase of sex. Mapping shifts in prostitution 7 years after Act came into force. - Displacement - Stigmatisation - Attitudes - Demand - Trafficking - Equality agenda	Limitations of mapping increases/decreases in prostitution through observation. Difficulties in estimating increase/decrease in trafficking hindered by differing law definitions.
Dodillet, S. and Östergren, P. (2011) The Swedish Sex Purchase Act: Claimed Success and Documented Effects	A review of research and reports on the criminalisation of purchase of sex in Sweden. Using material (mainly reports and also evaluations) from authorities that have been responsible for reporting on prostitution and evaluating the policy (incl National Board of Health and Welfare [a government agency under the Ministry of Health and Social Affairs]; the National Council for Crime Prevention [a council that functions as the government's body of expertise within the judicial system]; the National Police Board; the government 2010 evaluation of the Sex Purchase Act; and the responses of 52 referral bodies). These authorities have in their turn collected information from police, social workers, NGOs, academic research and some interviews with people with experience of prostitution.	n/a	Sweden	Impacts of the criminalisation of purchase of sex: - Demand - Trafficking - Attitudes - Corroboration - Stigmatisation	Utilises secondary data. Uncertainties regarding government prevalence data.
Fredlund et al. (2009) Adolescents' Lifetime Experience of Selling Sex: Development Over Five Years	Comparative study examining changes over time between 2004 and 2009. Questionnaire conducted with 3,498 adolescents from a representative sample of Swedish high school students with a mean age 18.3 years.	3,498 students (60% response rate)	Sweden	Young people	Group selling sex is small, and therefore the results should be interpreted with some caution.
Holmström, C. & Skilbrei, M. (2008) Prostitution in the Nordic Countries Conference Report Nordic Ministers for Gender Equality ( MR-JÄM) commissioned the Nordic Gender Institute ( NIKK) to carry out a research project to focus on the Nordic countries' differences and similarities in devising prostitution policies The project was launched in order to create a shared knowledge base that stems from a gender equality perspective.	Eleven Nordic researchers from various disciplines in the Nordic countries participated in the project over one year. (i) compile information about the scope of prostitution and human trafficking for sexual purposes. (ii)discussion of existing legislation by researchers from each of the 5 Nordic countries (iii)Examining of attitudes and beliefs on prostitution at country level. Kuosmanen's quantitative study on attitudes towards the Sex Purchase Act in Sweden; Jahnsen's qualitative study using media analysis in Norway; Martilla's focus on the debate on criminalisation of purchase and effects on attitudes in Finland; and, Atlason and Gudmundsdóttir review results from previous studies on attitudes and beliefs in Iceland regarding prostitution.	n/a	Nordic countries	Comparative study - Prevalence - Attitudes	Limited information on impacts of legislation criminalising purchase. Results from studies on attitudes and beliefs do not provide descriptive comparisons.
Huschke et al. (2014) Research into prostitution in Northern Ireland	Online survey with sex workers; online survey with clients; face-to-face interviews with sex workers and clients; interviews with experts and service providers; phone interviews with representatives of 9 councils across Northern Ireland; and, questionnaires for 7 organisations in different jurisdictions that offer support services for sex workers across the UK, the ROI, Sweden, the Netherlands and New Zealand. Also, conducted a review of policies regarding prostitution in other societies. Survey included respondents who buy and sell sexual services outside of NI.	Survey with sex workers: 171 respondents Survey with clients: 446 respondents Interviews with sex workers: 19 participants Interviews with clients: 10 participants Interviews with experts and service providers: 18 participants Phone interviews with representatives of 9 councils Questionnaires with support services: 7 organisations 44% of the sex workers who took part in the survey and 26% of the interviewees were foreign nationals.	Northern Ireland	Potential impacts of criminalisation of purchasing of sex. - Attitudes of sex workers to potential ban - Safety concerns - Challenges for corroboration - Displacement - Impacts on sex trafficking - Impacts on demand	Research conducted prior to NI criminalisation of purchase of sex and therefore findings are limited to perspectives on potential impacts. Survey data is not representative or based on a randomised sample. The majority of the clients who took part in the study predominantly used the internet to find sex workers/escorts so people who buy sex on the streets are under-represented.
Jakobsson and Kotsadam (2010) 'Do Laws Affect Attitudes? An assessment of the Norwegian prostitution law using longitudinal data'	Comparative study (with control group [Sweden]), using a difference-in-differences methodology [looking at the average difference over time], comparing the attitudes of Norway and Sweden. Quantitative longitudinal internet-based survey conducted in August 2008 and August 2009. Conducted with 15-65 year olds male and female from Norway and Sweden collected before and after Norwegian legislation criminalising purchase of sex.	Survey sent to a random sample of 2,500 Norwegians and 3,000 Swedes. Response rate in the first survey was 68.6% in Norway and 60.5% in Sweden. By end of second survey period, 1,034 Norwegians (41.4%) and 1,317 Swedes (49%) had responded to both surveys.	Norway and Sweden	Impacts of criminalisation of purchasing of sex. - Attitudes	Authors acknowledge caveats that may underestimate the effects of legal change on attitudes: (i)Results concern the short-run effects of law change on attitudes. (ii)Unable to distinguish between any 'direct effect' of the law and the effect attained via the media debate. (iii)Study does not include a wave of data before the implementation of the law in Norway, authors cannot test the assumption that change in average attitudes of Norwegians would have been the same without the new law as the change in average attitudes during the same period in Sweden. (iv)Unrepresentativeness of sample: 45.3% of sample has higher education in comparison to 31.8% of Swedes aged 16-65 nationally. 56.7% of Norway sample has higher education in comparison to 27% percent of Norwegians nationally.
Jonsson et al. (2014) '"Without the Internet, I never would have sold sex": Young women selling sex online'	Semi-structured interviews with young women (aged 15-25) who had sold sex online before the age of 18. Purposive sampling including through NGOs working with young people and through contacts with a network of professionals at Swedish psychiatric units and residential treatment clinics.	Interviews with 15 young women.	Sweden	The role the Internet plays in young women selling sex, focusing on the methods of contact and the characteristics of the communication online between the buyer and the young women.	Research does not examine the impact of criminalisation of purchase.
Kotsadam and Jacobsson (2014)	Survey responses from a longitudinal Internet-based survey sent out by TNS Gallup in August 2008 and 2009 - see entry above (Jacobsson and Kotsdam, 2010)
Krusi et al. (2014) 'Criminalisation of clients: reproducing vulnerabilities for violence and poor health among street-based sex workers in Canada - a qualitative study' *first empirical study of how criminalisation and policing of sex buyers shapes sex workers' risks for violence and poor health outside Scandinavia. The research for the Krusi et al. report was conducted by the Gender and Sexual Health Initiative ( GSHI) of the BC Centre for Excellence in HIV/ AIDS and the University of British Columbia as part a larger ongoing research study on the health and safety of street and off-street sex workers throughout Metro Vancouver.	Qualitative and ethnographic study triangulated with sex work-related violence prevalence data and publicly available police statistics. (i)Semi-structured interviews with sex workers. All had exchanged sex for money in the previous 30 days in Vancouver. (ii) More than 40h of ethnographic observation within known street-based sex work strolls in the city to assess level of police presence; shifts in working areas and police, sex worker and client interactions over an 11-month period post policy implementation (January-November 2013). (iii) Longitudinal quantitative data on prevalence of workplace physical and sexual violence among sex workers from the AESHA cohort (an evaluation of sex workers health access) (a community-based longitudinal study of over 800 sex workers with biannual follow up) were analysed by two 8-month time periods pre and post-policy implementation.	26 cisgender and 5 transgender women who were street-based sex workers participated in semi-structured interviews. Aimed to reflect variation in demographics (e.g. age, ethnicity and gender) and work environments (geographic neighbourhoods, variation in street and off-street solicitation and transaction spaces).	Vancouver, Canada	Impacts of criminalisation of purchase of sex. - Safety - Displacement - Increase/decrease in demand - Challenges for corroboration - Stigmatisation No mention of uptake of services to exit prostitution	Limited in drawing conclusions on the impacts of criminalisation of purchase as research is based on a demand-based sex work enforcement policy prioritising sex workers' safety. The study primarily reflects the experiences of street-based sex workers, who are disproportionately impacted by policing, and therefore is limited in terms of other segments of the sex industry.
Kuosmanen (2010) 'Attitudes and perceptions about legislation prohibiting the purchase of sexual services in Sweden' *Funded by the Nordic Institute for Gender Knowledge and the Section for Gender Equality at the Swedish Department of Integration and Gender Equality.	Survey with adults aged 18 - 74 in Spring 2008. Individuals randomly selected from the National Register of Population. Statistical analysis of survey data carried out. Forms part of a larger investigation on prostitution in the Nordic countries.	Survey with 2,500 individuals with 1,134 responses returned (45.4% response rate).	Sweden	Impacts of the criminalisation of the purchase of sex: - Attitudes - Demand impacts - Impacts of law specifically on attitudes - Perceived prevalence	Sampling: over-representation of women in sample (57% whilst they represent 49.4% as a whole) and under-representation of men particularly in the youngest age spans. Over-representation of those with a higher education (42% of respondents with a post-upper secondary education in comparison to 31% in the population as a whole).
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Levy, J. (2015) Criminalising the Purchase of Sex: Lessons from Sweden	PhD research. Mixed methodology of formal and informal interviewing and participant observation. Interviews with sex workers and with those with experience/expertise surrounding sex work including politicians, NGO workers, spokespeople for lobby, activist and rights groups, police, healthcare providers and social workers. Targeted sampling (and snowball) accessing sex workers through public spaces, networks and organisations. Conducted in Malmo and Stockholm.	Interviews 22 female sex workers (experience of street work (5), escort work (15), and stripping (8)). 2 male sex workers 2 transgender sex workers 4sex work clients 4 representatives from Swedish Drug Users' Union 4 representatives from Malmo Prostitution Unit And 3 from Stockholm Prostitution Unit 1 respondent from radical feminist organisation 4 representatives from drug use rights organisation 3 representatives from drug prohibitist organisation 5 from LGBT rights organisation	Sweden	Impacts of the criminalisation of the purchase of sex. - Sex workers' experience - Spatial displacement - Safety	Targeted and snowballing sampling leading to self-selection bias. Snowballing through organisations leading to some respondents being active in political debate, activism and/or service provision so sample represents specific group of sex workers.
Levy, J. and Jakobsson, P. (2014) 'Sweden's abolitionist discourse and law: Effects on the dynamics of Swedish sex work on the lives of Sweden's sex workers'	Utilises authors' respective research: (i)Levy's PhD research including interviews and ethnographic participant observation with sex workers and clients as well as interviews with practitioners. (ii) Jakobsson's research involving an internet-based survey. Also draws on secondary research.	Levy: 22 cisgender female sex workers (5 street workers, 15 escort workers and 8 who had worked in stripping); 2 male sex workers; 2 transgender sex workers; and 4 sex worker clients. Jakobsson: internet-based survey with 124 respondents.	Sweden	Impacts of the criminalisation of the purchase of sex: - Sex workers' experience - Spatial displacement - Safety - Targeted service provision and impacts - Prevalence	Methodologically difficult to achieve a representative sample of sex workers.
Mujaj, E. and Netscher, A. (2015) Prostitution in Sweden 2014: The extent and development of prostitution in Sweden *County Administrative Board of Stockholm commissioned by the Government.	Scoping survey gathering old and new knowledge provided by various stakeholders including: online surveys, National Board of Health and Welfare Report on the Development of prostitution 2015, a population survey, civil society contacts with persons selling sexual services and the police. Mapping with in depth focus on online prostitution.	n/a	Sweden	Prevalence	Difficult to draw comparisons between and within countries over time on extent of prostitution/human trafficking without single definition. Difficulties in estimating the actual number of individuals behind online ads. Gaps in knowledge on numbers of unaccompanied minors subject to prostitution. Women of non-Swedish origin are not reached by population studies and are therefore not represented in these types of surveys.
Niemi, J. & Aaltonen, J. (2014) Abuse of a victim of sex trade Evaluation of the Finnish sex purchase ban *Ministry of Justice Finland * Finland has partial criminalisation and evaluation principally examines the 2006 law prohibiting the purchasing of sex from a victim of human trafficking or procuring as well as focusing on S7 of the Public Order Act 2003 which prohibited to purchase sexual services or to offer sexual services against payment in a public place.	Mixed methods including: (i)Statistics and register data. (ii)Interviews with experts including experts from various units of the police, the prosecution service, the Border Guard, the social services and NGOs. (iii) Online survey among NGOs and authorities to explore more broadly how they have come into contact with issues of prostitution and the purchasing of sex. (iv)Review of court documents. Various courts were requested to submit decisions where defendants were convicted of abuse of a victim of sex trade, human trafficking or procuring. Quantitative data on the application were collected from public statistics by national Statistics Finland, from various units of the police, from public prosecutors and from courts.	Interviews with 24 experts. The online survey was sent to 20 recipients, of whom seven responded.	Finland	Impacts of partial criminalisation of purchase of sex: - Prevalence - Attitudes - Application of law	Finland criminalises buying and selling in public place and has partial criminalisation of purchasing of sex from a victim of human trafficking or procuring.
Norwegian Ministry of Justice and Police Affairs (2004) Purchasing Sexual Services in Sweden and the Netherlands Legal Regulation and Experiences An abbreviated English version A Report by a Working Group on the legal regulation of the purchase of sexual services	Working group of 3 academics/police representatives appointed by Norwegian Ministry of Justice to collect experiences for/against criminalisation of purchase of sexual services. Methods include: (i) Assessment of police and social services prevalence data on street prostitution post-ban as well as data on indoor market. (ii)Gathering experience from informants from organisations representing those who sell sexual services. Limited to consulting with 2 members and 1 board member of one organisation (National Organisation for Sexual Workers) and utilised interviews from Ostergren's published Master's thesis.	n/a	Sweden	Impact of criminalisation of purchase of sex: - Experience of sex workers - Experience of national police forces in application of the law. - Implications re corroboration	Variations in observation data between social services and the police. Limited number of active organisations to gather experience from.
Östergren, P. (2004) Sex workers critique of Swedish Prostitution Policy *unpublished Swedish masters dissertation translated into English	Interviews, informal talks and correspondence with approximately 20 sex workers since 1996, as well as published and broadcasted interviews with sex workers in Swedish media. It is also based on interviews with people working with women selling sex to support a drug habit (most of whom also are homeless).	Not provided	Sweden	Impacts of criminalisation of the purchase of sex. - Experiences of sex workers	Limited English summary of findings of Ostergren's masters' research.
Rasmussen et al. (2014) Evaluation of Norwegian legislation criminalising the buying of sexual services (summary). *English summary report	Government-appointed academic evaluation of the effects of the 2009 Norwegian legislation. Estimating the size of the prostitution market post 2010 based on observational data.	n/a	Norway	Impacts of criminalisation of purchasing of sex. - Demand - Trafficking - No evidence of more violence	Data on prevalence based on observations and issues with comparing this over the years.
SOU (2004) Prostitution in Sweden 2003 Knowledge, Beliefs & Attitudes Of Key Informants *National Board of Health and Welfare 2nd report	Interviews (mostly individual but some in groups) with individuals whose work involves dealing with prostitution largely from social services and the police.	Interviews with 35 individuals	Sweden	Impacts of the criminalisation of the purchase of sex: Prevalence	Focused on Malmö, Stockholm and Goteborg only.
SOU (2008) Prostitution in Sweden 2007 *National Board of Health and Welfare Sweden 3 rd report	Mixed method including interviews (individual and group), surveys and a systematic study of prostitution contacts on the World Wide Web. (ia)Semi-structured interviews with informants from public authorities and NGOs interviewed who have direct or indirect knowledge of prostitution in Sweden (Malmö, Göteborg, Stockholm, Luleå, Umeå and small towns in central Sweden). (social services, police, and other organisations). (ib)Semi-structured interviews with sex workers and purchasers recruited via posted queries via the Web and posted notices about the study at shelters with element of snowball sampling. (ii)Surveys distributed to all police authorities in Sweden and to a sample of Swedish municipalities and to youth clinics. The data in the collected municipal surveys were compiled and the results computed by extrapolating to the national level. Thus, the figures in the report show the estimated number of municipalities that have knowledge of prostitution in the municipality. (iii)web research study of information posted on websites over 6 weeks period.	Interviews : 40 actors -14 sellers of sexual services (including 6 interviewed by email, of whom 5 have a history of street prostitution and 1 who has left prostitution) -2 clients, including 1 interviewed by e-mail -2 former "promoters" of trade in sexual services -6 representatives of the police, 14 representatives of municipal social services, 4 representatives of NGOs Survey: Randomly selected sample of 100 municipalities. Of the 100 municipalities queried, 71 responded to the surveys and of 21 police authorities queried, 17 responded. Follow-up questions conducted with 25 municipalities and 12 police authorities that had knowledge of prostitution. 2 of 15 youth clinics responded. Web research study: The database prepared for the study contains data about 299 unique URLs where people working in various parts of Sweden sell sexual services.	Sweden	Impacts of the criminalisation of the purchase of sex: - Attitudes - Marginalisation - Safety	Evaluation acknowledges several limitations: (i) Initial distrust among those with personal experience of prostitution when contacted about interview specifically why the National Board of Health and Welfare wanted to talk to them. (ii)Both prostitution teams and sellers of sexual services had opinions about the previous reports. (iii)Some women in prostitution confused the Board with the social services, with which they had several associations. (iv)Unable to interview any men who sell sexual services, victims of human trafficking or recently arrived immigrants who sell or buy sexual services. Also, able to reach only a few people who have left prostitution. (v)People involved may have had vested interests in promoting certain information based on their mission, ideological grounds, orientation, experience, need for funding, etc. (vi)Limited data collection period for the web research study may under-estimate number of sellers.
SOU (2010) Evaluation of the prohibition of the purchase of sexual services *English summary available of inquiry available as well as a translation of chapters 4 and 5 on 'Prostitution in Sweden 1998-2008' and 'A comparison to the situation in some other countries'	Swedish government commissioned evaluation on the ban against the purchase of sexual services led by a specially appointed committee. Committee of inquiry used a variety of sources, including a substantial number of studies, reports and other publications that deal with issues of prostitution and human trafficking for sexual purposes. It also gathered information from individuals who work with these issues and from others who have personal experience with prostitution.	n/a	Sweden	Application of the ban in practice. Prevalence post ban. Uncertainties around application of the law - implications re corroboration.	Evaluation criticised in literature for weak empirical base. Also, evaluation starts from the premise that purchase of sexual services remain criminalised. Difficulties of assessing prevalence of prostitution in arenas other than street settings i.e. via internet. A lot of knowledge/research shaped by operational focus and perspective of the agencies and organisations concerned.
The Swedish National Board for Youth Affairs (2014) See Me English version summary *** The report is based on a number of separate quantitative and qualitative studies that have been conducted by the Board itself, by qualified academics working at Swedish universities and by RFSL Ungdom (Sweden's national lesbian, gay, bisexual and transgender youth organisation).	2 surveys' findings drawn on: (1) A survey with year 3 (18 year old students) with comparisons made to a similar government survey carried out in 2004. (2) A youth survey of 16-25 year olds.	Not provided	Sweden	Attitudes to sex in return for payment Role of internet	Research does not examine the impact of criminalisation of purchase. Difficult to draw any conclusions as to whether the internet is responsible for the more positive attitudes found among young people towards buying and selling sex. Nor is there anything to suggest that the internet in itself has led to any increase in the number of young people who have actually sold sexual services.